Abstract

Minimally invasive or totally endoscopic cardiac surgery is an operation technique in which
physicians operate through small incision points at the cardiac region, in contrast to open
chest surgery. A master-slave telemanipulator system, like the da Vinci, allows the insertion
of very small instruments and imitates physicians’ hand and finger movements from their
remote console. In order to perform a precise operation these incision points and their orientation
need to be placed in such a way that there will be no conflicts. Thus, a planning tool
in combination with intra-operative navigation support for the port placement is required.
The intra-operative navigation is implemented in this work. Current scenarios lack the
presentation of preoperative aquired image data, like computed tomography images. Thus,
these image data has to be registered in three dimensions with the patient’s thorax. Augmented
reality technology enables the projection of the previously planned optimal pose
for the port placement on top of the view of the real world. The proposed application will
provide physicians with a usefull visualization interface to see inside the patient.
A registration procedure is required in order to perfectly align the modalities, both real
and virtual, in the spatial domain. Therefore, a point based algorithm, on the basis of fiducials,
is used to compute the transformation. Those external markers are placed on the patient’s
skin and are visible in the computed tomography scan and in the tracking environment
in the operating theater.
The developed prototype superimposes the planned port data on top of a video frame of
the real world after a perfect spatial registration. Additionally, a tool was implemented that
shows the tracked telemanipulator arms during the entire operation in the virtual model of
the patient.

Minimally invasive or totally endoscopic cardiac surgery is an operation technique in which physicians operate through small incision points at the cardiac region, in contrast to open chest surgery. A master-slave telemanipulator system, like the da Vinci, allows the insertion of very small instruments and imitates physicians’ hand and finger movements from their remote console. In order to perform a precise operation these incision points and their orientation need to be placed in such a way that there will be no conflicts. Thus, a planning tool in combination with intra-operative navigation support for the port placement is required. The intra-operative navigation is implemented in this work. Current scenarios lack the presentation of preoperative aquired image data, like computed tomography images. Thus, these image data has to be registered in three dimensions with the patient’s thorax. Augmented reality technology enables the projection of the previously planned optimal pose for the port placement on top of the view of the real world. The proposed application will provide physicians with a usefull visualization interface to see inside the patient. A registration procedure is required in order to perfectly align the modalities, both real and virtual, in the spatial domain. Therefore, a point based algorithm, on the basis of fiducials, is used to compute the transformation. Those external markers are placed on the patient’s skin and are visible in the computed tomography scan and in the tracking environment in the operating theater. The developed prototype superimposes the planned port data on top of a video frame of the real world after a perfect spatial registration. Additionally, a tool was implemented that shows the tracked telemanipulator arms during the entire operation in the virtual model of the patient.